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Protecting against measles in Indonesia
© UNICEF/IDSA10/Purnomo
Protecting against measles in Indonesia

The Issues

Immunization in our region has achieved some notable successes in recent years – measles deaths have fallen dramatically while tetanus among newborns, a disease grossly under-reported, remains endemic in only seven countries. In recent years, several countries, including Cambodia, Lao PDR and Papua New Guinea, have introduced new vaccines, such as the Haemophilus influenza B vaccine, protecting their children against bacterial pneumonia and meningitis, a common killer of young children. But many infants still miss out on life-saving vaccines.

  • Risk of complacency. Due to the success of immunization programmes, the number of deaths from vaccine-preventable diseases has visibly decreased across the region. Some governments have therefore shifted their priority focus, and thus investment in immunization programmes has stagnated. Such a shift could set back the significant gains made against traditional childhood killers. With the reduction in vaccine-preventable diseases, families may no longer see the value in immunizing their children and may even become more afraid of the vaccines than the diseases. For example, polio re-emerged in Indonesia in 2005 – ten years after the last case was seen in the country.
  • Measles is still the cause of vaccine-preventable deaths, despite the availability of an effective, affordable vaccine. Only a handful of countries in our region attain or exceed 95 per cent immunization coverage with the first dose of vaccination, creating pockets of lower immunity. And while all countries offer a second-dose opportunity for the measles vaccine, only about half of them offer it in the routine delivery system (as opposed to periodic immunization campaigns).  
  • Inadequate use of data.  Many countries have weaknesses in the quality of data-reporting systems from the periphery to the central levels. Furthermore, the analysis of data is not always optimized. Without quality data, micro planning to pinpoint areas and populations where special attention is needed remains inadequate. 
  • Challenges with financial sustainability. Newer vaccines available on the market, such those to prevent rotavirus, pneumococcal and Human Papillomavirus (HPV), are effective and yet much more costly than traditional vaccines. In the past ten years, some countries have seen their programme costs increase more than five-fold due to the introduction of Hepatitis B and Haemophilius influenza B vaccines. Mobilizing adequate resources from national and donor sources will continue to be a serious challenge for the foreseeable future. 
  • Poverty and other factors deny children immunization services. Other obstacles include inadequately resourced or poorly structured health systems, geographic and socioeconomic barriers to accessing the health system, vulnerability of certain populations or ethnic groups, and weak infrastructure, including the cold chain.

Protecting against polio in Cambodia
Protecting against polio in Cambodia

UNICEF in Action

UNICEF continues to regard immunization as an important priority in the region. Our immunization activities cover:

  • Supporting mass immunization campaigns against polio, measles and tetanus while seeking opportunities to integrate with other health services, such as the distribution of vitamin A supplements, deworming or long-lasting insecticide impregnated nets. 
  • Developing communication and advocacy strategies to promote the value of immunization and increase community demand.
  • Improving the quality and sustainability of routine immunization programmes through technical and financial inputs in policy design, resource mobilization, cold chain and logistical improvements and stronger service delivery, programme reporting and monitoring.
  • Providing support to governments to introduce new vaccines to prevent childhood killers, such as meningitis, pneumonia and diarrhoea. 
  • Assisting countries in securing the financing of uninterrupted vaccine supplies and immunization services.



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